Inspection on 30/05/06 for Muscliff Nursing Home

This inspection was carried out on 30th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Muscliff Nursing Home 19/07/07

Muscliff Nursing Home 13/10/05

Muscliff Nursing Home 18/05/05

Muscliff Nursing Home 26/01/05

Muscliff Nursing Home 17/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Muscliff 5 Tolpuddle Gardens Muscliff Bournemouth Dorset BH9 3RE Lead Inspector Hilary Cobban Key Unannounced Inspection 30th May 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000020452.V296353.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000020452.V296353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Muscliff Address 5 Tolpuddle Gardens Muscliff Bournemouth Dorset BH9 3RE 01202 516999 01202 516371 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Muscliff Medical Limited Miss Dedrey Charles Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places DS0000020452.V296353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The issued staffing notice must be adhered to at all times and staffing levels increased to meet the dependency levels of service users as necessary. One named person (as known to the CSCI) with a learning disability and under the age of 65 years may be accommodated. 13th October 2005 Date of last inspection Brief Description of the Service: The Registered Providers are Muscliff Medical Limited, a group of four doctors and a pharmacist, who registered and opened the purpose built home in 1997. Muscliff Care Home is situated in the northern part of Bournemouth, close to the rural area of Throop, with a neighbouring Medical Centre, Pharmacy, convenience store and community facilities. The home is registered to accommodate 40 service users within the category of old age requiring nursing care. The bedrooms on the first floor are accessed by a passenger lift and the corridors are all spacious with wide doorways. All rooms are for single occupancy and provide en-suite facilities. The home is set in attractive gardens laid mainly to lawn with shrubs, herbaceous borders, paved areas and an ornamental pond. The fees at the home are currently between £675 and £725 per week. DS0000020452.V296353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection took place over a period of seven hours during which all key standards were inspected and various other standards. The inspector was welcomed to the home by a senior nurse as the Registered Manager was on annual leave. She kindly joined the inspector for two hours in the afternoon to ensure that all the information was made available. The inspector spoke to eleven service users, two relatives and four members of staff as well as having a worthwhile discussion with the Registered Manager. The service users appeared satisfied with the service, with particular comments made about the Registered Manager and other members of staff. During a tour of the premises the inspector observed the care of other service users and the decorative state of the home. The inspector examined a variety of records including three recruitment records and four care records. There were five vacancies in the home on the day of the inspection. What the service does well: Muscliff is suitably designed for the provision of full nursing care with thoughtful provision of disability aids which encourage and maintain maximum levels of independence. Privacy is of paramount importance. The provision of activities is imaginative and varied and geared to individual requirements. The meals are served with style and provide an interesting well balanced diet with real choice and special wishes catered for. One service user stated that the “food is good and plentiful”, another “food good but a bit rich” and another “chef does his best to accommodate”. The home has robust policies in place for the Protection of Vulnerable Adults and places great emphasis on equal opportunities for all staff and service users. The staff are offered training to improve their individual development as well as the mandatory training. The home is accredited for the adaptation of qualified immigrant staff and as a training placement for student nurses. The Registered Manager is highly motivated and communicates well with staff and service users through a planned programme of meetings, letters and notices. One service user stated that “can say if something not right”. DS0000020452.V296353.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000020452.V296353.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000020452.V296353.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The inspector found that the home had the correct systems in place, including a comprehensive statement of purpose, contract and preadmission assessment, to ensure that each service user is moving into a home that can meet their individual care needs. EVIDENCE: The service user guide has been thoughtfully produced and is written in simple English and includes the complaints procedure. It also informs the prospective service users that they will be visited prior to admission and then if the placement is appropriate for their needs, they are invited to visit the home for a two week trial period. One service user spoken to confirmed that his relatives had assisted with the placement but he had not actually had the opportunity to visit the home himself. DS0000020452.V296353.R01.S.doc Version 5.2 Page 9 The inspector examined the preadmission assessment records, which were usually carried out with the assistance of a relative or other representative, and found that each contained sufficient information to enable the Registered Manager to make a decision as to whether the home could meet the care needs. Some of the information seemed a little sparse but the Registered Manager was able to justify this. The home should write to the prospective service user to confirm this decision in line with regulation 14 (1)(d) of the Care Home Regulations 2001. The facilities available within the home are suitable for the category of service user accommodated, with qualified nurses and other skilled staff, access to specialised services, custom built well furnished rooms and appropriate health and safety provisions. The Registered Manager assured the inspector that she could meet specific minority requirements. Contracts are issued to service users, which specify terms and conditions, and the inspector found these to meet legislative requirements. The home does not offer intermediate care. DS0000020452.V296353.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. There is sufficient information in the care plans to ensure that the care needs of individual service users are met. This was re-enforced by daily records, a variety of risk assessments and records of involvement by other professionals. The service users spoken to felt that they were treated with privacy and dignity. EVIDENCE: The inspector examined four care plans and found that there had been an improvement since the last inspection with particular regard equality and diversity. The care plans included comprehensive details of the following: Consent to photo Consent to resuscitation Full medical details Visits by General Practitioners and Consultants DS0000020452.V296353.R01.S.doc Version 5.2 Page 11 Visits by multidisciplinary team National Health Service Nurse assessment Variety of Risk Assessments including Wound assessments Record of outings Etc. The daily records are kept in separate files and it was not always evident that there had been direct reference made to the care plans. There are also communication sheets for the use of the keyworkers. The care reviews are now more meaningful and are carried out frequently and involve the service user or their representative. The Registered Manager had written to all staff after the last inspection to alert them all to the importance of accurate consequential reporting. It was clear to the inspector that the service users had access to a variety of professionals including the Macmillan Palliative team, dentist, optician, chiropodist, occupational therapist and speech therapist and all other benefits as specified by the National Services Framework for Older People. Attention is given to anyone identified at risk of pressure sores and a suitable mattress supplied. The medication is administered competently by a dedicated member of staff who ensures that the ordering, dispensing and disposal of all medicines is in line with recommendations made by the Royal Pharmaceutical Society. The fridge temperatures on the medicines fridge continue to cause concern which might compromise the status of the medication although recently the readings had been within recognised limits. A new fridge is currently on order. The inspector noted that doors were knocked and the privacy of the service users maintained at all times and the service users confirmed this. The staff treated all the service users with respect, calling them by the name of their choice. DS0000020452.V296353.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made from evidence gathered both during and before the visit to this service. Everyday life in the home is appropriate to the needs of the service users and each individual is offered activities according to their wishes. Visitors are welcomed so that contact is maintained. The mealtimes are a focus of the day and the service users are offered an appealing well balanced diet which meets their nutritional requirements. EVIDENCE: Two full time activities organisers enable activities to be provided seven days a week. The service users spoken to were full of admiration for the Activities Organisers, who work with the service users to arrange a varied recreational programme, which includes visits to the beach, boat trips, outings to a garden centre as well as individual arrangements. The service users were very appreciative of even the most simple trips, such as around the pleasant gardens and also commented on the entertainers who come to the home on a regular basis and parties held within the home. There is a regular newsletter and posters which alert the service users to diary fixtures. There is a file which DS0000020452.V296353.R01.S.doc Version 5.2 Page 13 records contact with the community and letters from various church representatives which confirms that regular services are held within the home. Some service users are not willing or able to participate in these activities and their wishes, both emotional and spiritual are respected and identified in the care files. All have access to library books, newspaper, TV and radio. Visitors called at the home throughout the inspection and were welcomed by the staff. They could meet with the service user in the privacy of their own room or in one of the pleasant sitting rooms. Some service users had their own telephones and some used mobile phones. The service users felt that they had plenty of choice as regards the aspects of daily living and many had brought personal belongings into the home to personalize their rooms. Some looked after their own financial affairs and it was noted that an advocacy service was available. The dining room was exceptionally attractive with superior napery, attractive table settings and daily menus on each table. The menus were imaginative and the meal observed by the inspector was appealing, wholesome and individually designed for the needs of the service users with choice at every meal. Assistance was given by the care staff where required in a discrete and sensitive manner. The inspector spoke to the chef who identified food likes and dislikes and allergies for every new admission and also kept records of letters from dieticians. Special diets could be catered for. The kitchen was inspected by the Environmental Health Officer in December 2005 and a fan had subsequently been replaced. The cupboards identified more than adequate supplies of fresh food including fresh fruit and vegetables and a daily delivery from the butcher. DS0000020452.V296353.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The complaints procedure ensures that any complaints will be acted upon appropriately. All service users have their legal rights protected, calling on an advocate when necessary. The policies and procedures ensure that all service users are safeguarded from abuse. EVIDENCE: There is a complaints file in place with forms and envelopes readily available which will ensure that each complaint will be treated with the utmost confidentiality. A complaints log is kept and there have been no complaints made since the last inspection. Staff, service users and visitors are all aware of the of the procedures but it was suggested that the Registered Manager give more thought to the criteria applied to complaints in line with new policies currently being developed by the Commission for Social Care Inspection. The administration staff stated that service users are registered on the electoral role but were unable to provide evidence of this have a postal vote but where possible service users are taken to the polling station and a service user confirmed this. There was evidence of the use of an advocate. DS0000020452.V296353.R01.S.doc Version 5.2 Page 15 The staff spoken to were aware of the policies and procedures (including Whistleblowing) which are in place to protect the service users from any form of abuse and regular training is given in line with the Department of Health Guidance (No Secrets). Restraint in the form of bedrails and lap straps is accurately documented and agreed to by the service user or their representative. The Registered Manager has recently revised her Equal Opportunities Policy with a confidential reporting form, which covers service users, staff and job applications, which gives protection to all. DS0000020452.V296353.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24, 25 and 26 Quality in this outcome area is excellent. This judgement has been made from evidence gathered both during and before the visit to this service. The home is well maintained to make certain the safety and welfare of service users. The custom built home was designed in conjunction with an Occupational Therapist in a manner which ensures that there are facilities to assist those with physical disability. The bedrooms are all of a suitable size to accommodate sufficient furniture as well as personal possessions. The home was clean and free from odour ensuring pleasant surroundings which complied with infection control guidance. DS0000020452.V296353.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home is easily accessible, with bedrooms on the first floor accessed by a passenger lift. There is a regular programme of maintenance and the budget for this year includes new non-permeable floors in all en-suite facilities which has already been carried out and a planned refurbishment of the bedrooms as they become available, several of which now have new soft furnishings as well as redecoration. The gardens are well maintained and there is no use of CCTV which would compromise the privacy of the service users. The home has been thoroughly assessed by an Occupational Therapist and there are adequate hoists and other disability aids. The corridors and doors are wide enough for wheelchairs access. All the bedrooms are for single occupancy and have appropriate bells, lighting and heating. Many are personalized with small items of furniture and pictures. There are locks on all doors and also a lockable facility within the room for the safe keeping of valuables. There are records to support the testing of water to comply with legislation for the prevention of the spread of infection and other measures taken in the laundry and food preparation areas. The laundry has suitable washing machines and dryers and complies with policies and procedures in place within the home. Staff were noted using protective clothing and there are suitable hand washing facilities. DS0000020452.V296353.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The home has sufficient staff on duty to ensure that the needs of the service users are met. There is an active training programme to ensure that suitably qualified staff are caring for the service users. There is a recruitment procedure in place but omissions were noted which might compromise the safety of the service users. EVIDENCE: The inspector examined the staff rota and spoke to the members of staff on duty at the time and found that the numbers allocated are in line with previous recommendations. The staff and service users spoken to agreed that there were sufficient staff employed and the inspector noted that service users needs were attended to without unnecessary delay. There is a high proportion of immigrant staff, which can cause problems in communication even though new members of staff have to complete a language proficiency form. All the staff spoken to were happy in their work, one stating that “it is wonderful working here”. DS0000020452.V296353.R01.S.doc Version 5.2 Page 19 There are currently 22 care assistants employed of whom seven have completed their National Vocational Qualification in Care Level 2 and a further five are currently in training, which will ensure that the home meets the requirements of Standard 28 of the National Minimum Standards. The training records evidenced that all care staff have received training in health and safety, first aid, manual handling, food hygiene and infection control. This was confirmed by the staff spoken with during the inspection. Staff files of three recently recruited members of staff were examined and found to contain a great deal of information including two references, certification of registration from the Nurses and Midwives Council, Job Description, proof of identity, contract of employment and health questionnaire. There were also signed agreements in connection with the Working Time Directive, policy for Gifts and Code of Conduct. All had a satisfactory enhanced check with the Criminal Records Bureau but one new recruit had not received a Protection of Vulnerable Adults first check BEFORE commencing work for which a requirement has been made again. It was also recommended that any gaps in employment history should be identified. Staff receive regular training in line with the National Training Organisation workforce training targets and are in the process of further foundation training which will lead on automatically from the induction. DS0000020452.V296353.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 37and 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The Registered Manager is competent and runs the home in a manner which ensures that the service users feel confident and safe. Her management approach is open and inclusive and shows a genuine commitment to equal opportunities. There is a quality assurance system in place. Robust records are in place where the home accepts personal funds for service users. Other records required by The Care Homes Regulations are also in order and kept secure where necessary. The Registered Manager ensures the welfare of service users and staff at all times, using appropriate procedures and complying with appropriate safety legislation DS0000020452.V296353.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Registered Manager has been in post since April 2005 and has worked hard, with great commitment to ensure a continuing programme of improvement, introducing various new procedures. She is highly thought of by staff and service users and relatives who all find her very approachable. She has improved communication with the introduction of a communication file and holds regular meetings with qualified staff, health care assistants and service users. The inspector found her enthusiastic and highly motivated. The Registered Person holds regular meetings with her and has tried to clarify the lines of accountability, though there is still room for improvement in this area. There is a Quality Assurance Scheme in place and the results of this are used as a basis for discussion between management. The policies are reviewed regularly and reviewed where necessary. There are comprehensive records of the clinical supervision of care staff, which is delegated to the qualified staff. The home is an accredited centre for the adaptation course for immigrant staff and also for training placements for student nurses. Small amounts of personal monies for a number of residents every day use is held in separate envelopes within a locked safe. Records of transactions are maintained. The home employs an administrator who is responsible for the day-to-day financial management of the home. Records are kept in line with all legislation, with the accident records secured according to the Data Protection Act 1998. All these accidents are audited on a monthly basis, graphs drawn up and appropriate action taken. The Registered Manager cares for the safety of service users by ensuring that all staff have regular mandatory training in infection control, health and safety, moving and handling, fire safety and first aid. The kitchen staff all have training in food hygiene. There are good records of the maintenance and servicing of equipment used within the home and the home complies with the requirements of the Fire Service. There are comprehensive Control Of Substances Hazardous to Health records. DS0000020452.V296353.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 2 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 DS0000020452.V296353.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP4 Regulation 14 (1)(d) Requirement The Registered Manager must confirm in writing to the service user that the home can meet the assessed care needs The registered person must ensure that all staff have received a satisfactory enhanced CRB or POVA first check before commencing employment. This was a requirement at the inspection carried out on 13/10/05 Timescale for action 01/10/06 2. OP29 19 schedule 2 01/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations Any gaps in employment history should be identified. DS0000020452.V296353.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000020452.V296353.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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